Choosing Your Care Provider
Questions You Should Ask
When it comes to shopping for women's health care, the bottom line is: be an informed consumer. If this is your first pregnancy or first pelvic exam, you may be shy or fearful. Many women feel this way, but don’t let your emotions prevent you from receiving the best possible care. Ask your friends, colleagues and relatives for recommendations for a health care provider.
Then, follow your instincts. Every woman is different, and you are the only one who can know what is best for you. Make an appointment to interview your prospective provider and bring a list of questions with you to the interview. Ask any and every question that comes to mind, no matter how silly or embarrassing it might seem. No question should go unasked, and you should feel confident asking your provider about anything. Remember, you are the consumer and it is fine to “shop around” until you find the provider who is just right. Ideally, you should establish a relationship with a provider prior to pregnancy. Consider scheduling a preconception visit in order to be prepared and in the best health when you do become pregnant.
Common questions you might ask your midwife might include:
- Ask questions about the practitioner’s education and experience. What setting does he/she prefer for delivery?
- What percent of your patients deliver vaginally? How many have a cesarean section? Episiotomy? Epidural?
- Who are the other providers in the practice, and will you get to meet them? Who covers the practice if your provider is unavailable? Do they share the same philosophical approach as the person you are interviewing? If you will be seeing a midwife, ask about the physician consultant. What is his or her philosophy of birth? His or her cesarean birth and induction rates?
- Be sure to ask about the rate for elective inductions and the circumstances in which the provider might recommend an elective induction.
Individual practices keep their own statistics on these aspects of birth. The information provides a measure of how those individual midwives and physicians work, their outcomes and philosophy of care. A high rate of epidural anesthesia tells you that medicated birth is the norm. The cesarean rate indicates the likelihood of a surgical birth.
Some providers will try to avoid answering these questions—saying they perform the procedures only as necessary. Still, you should ask for specific numbers. Remember, you are the consumer buying the services, and you have a right to know what to expect. Request a list of all of the vaccines, ultrasound and laboratory testing that they recommend, and get questions answered in advance:
- Do you require sonograms, and if so, how often are they performed? Are there any other special tests that are required, other than routine prenatal blood work?
- What role will my birth partner play?
It is standard now for family or birth partner(s) to remain with a woman throughout labor and delivery, although the amount of participation varies. Remember, it is your birth and you set the stage for the degree of involvement that your partner has in the pregnancy, labor and delivery. When applicable, ask about having your children present at the birth.
- How much time do you allot to each prenatal visit, and for return of phone calls?
- What kind of feeling do you get when you enter the office? Is the office staff friendly?
- 9. Can I get a tour of the hospital where I might be delivering? Can I meet some of the nursing staff?
Look around the waiting room and ask women who are well into pregnancy how long they usually wait. If your blood pressure shoots up at every visit because the wait is making you late for work, your pregnancy will not be enhanced.
If choosing a home or birth center delivery, there is always a possibility that transfer to a hospital may become necessary; so, arrange to take a tour of the hospital. You will want to see the labor and delivery rooms, meet the staff, and find out where to park and how to proceed while in labor, or during an emergency care visit.
Additional questions:
- Are you licensed to practice in this state?
- Do you hold a current certification from the American Midwifery Certification Board (AMCB) or the North American Registry of Midwives (NARM)?
- What is your educational background? Do you have a college degree from an accredited midwifery education program, or did you receive apprentice training? (ACNM recommends that midwives attend an accredited midwifery education program in addition to receiving hands-on clinical experience.)
- How will we determine if I am an appropriate candidate for midwifery care?
- What services will you provide during my pregnancy, labor, and after childbirth?
- Do you offer home visits?
- Will I see a physician during my pregnancy? What will happen if complications arise during my pregnancy in which I need the care of a physician?
- Do you also provide gynecological services, health screenings, and well-woman care? Do you work with other providers, such as nurse practitioners?
- Is there any provision for pediatric care?
- Can you prescribe medications if I need them?
- Are your services covered by health insurers? Which ones?
- In the case of home or birth center birth:
- Am I an appropriate candidate for home or birth center birth?
- What is your experience in doing out-of-hospital births?
- Which hospital would we go to if a transfer is needed? Do you have privileges there?
- What can we expect if that happens?
- What is your transfer rate? (How many of your patients have needed to be transferred to the hospital during labor?)
- Can I speak to some clients you have worked with in the past?
Find Your Midwife
ACNM’s Find a Midwife practice locator service is the best starting point for anyone searching for a midwife.
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